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Shepherd of the Hills Lutheran School & Child Care PHYSICIAN S STATEMENT OF GOOD HEALTH & IMMUNIZATION RECORD 2015 2016 This form MUST be completed by a physician and returned no later than 08/01/2015
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How to fill out statement of good health
How to fill out a statement of good health:
01
Begin by carefully reading through the form and understanding what information is required.
02
Provide your personal details such as full name, address, date of birth, and contact information.
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Declare any pre-existing medical conditions, if applicable. Be honest and thorough when disclosing any health issues.
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If necessary, provide information about any medications you are currently taking or any recent medical treatments or surgeries.
05
Answer any questions or statements about your overall well-being, lifestyle habits (such as smoking or drinking), and any past hospitalizations or illnesses.
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If required, have your statement of good health signed and dated by a healthcare professional, such as a doctor or nurse practitioner, to verify your health status.
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Double-check all the information you have provided before submitting the form to ensure accuracy.
Who needs a statement of good health:
01
Individuals applying for life insurance policies may be required to provide a statement of good health to assess their overall well-being and identify any potential risks.
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Some employers may request a statement of good health before hiring or during the onboarding process to ensure that employees are physically fit to perform their duties.
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Students participating in certain academic programs or sports activities may need to submit a statement of good health to ensure they are physically capable of participating.
It is important to note that the specific requirements for a statement of good health may vary depending on the purpose and the organization requesting it. Always carefully review the instructions provided and provide accurate and truthful information.
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What is statement of good health?
The statement of good health is a form that declares an individual's current state of health.
Who is required to file statement of good health?
Individuals who are applying for certain health insurance policies or seeking coverage above a certain amount may be required to file a statement of good health.
How to fill out statement of good health?
The statement of good health can typically be filled out online or on paper, and requires the individual to provide information about their medical history, current health status, and any relevant health conditions.
What is the purpose of statement of good health?
The purpose of the statement of good health is to assess an individual's health status and determine their eligibility for certain health insurance policies or coverage.
What information must be reported on statement of good health?
Information such as medical history, current health status, any existing health conditions, and medication being taken must be reported on the statement of good health.
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